BillsFanNC Posted October 10 Posted October 10 6 minutes ago, Commsvet11 said: Now Now he will just say doctors don’t need to understand that Well he is Quack, MD after all... Quack is right about one thing. I don't have time to do any of that development work anymore. I now sell instruments, reagents and my consulting time to the scientists doing that type of work. Much better use of my time and it leaves me extra time many days to post here and send him into TDS rage posting. So I've got that going for me, which is nice. 3
Joe Ferguson forever Posted October 10 Posted October 10 5 minutes ago, Commsvet11 said: As an attending you should understand laboratory testing and results for diagnosis. Currently it doesn’t seem you do, you think Covid is a chemistry department test, Micro would have been acceptable answer more specifically in molecular or virology sub department because as a physician you should know Covid is a virus. We don’t have virology departments in our hospitals. These tests are done on cassettes on idiot proof instruments just like chemistries. Even you could do them. But toxicology. Yeah. Different story. And bs, I don’t need to know what subdept of the lab does any test. I used to do plasma catecholamine assays at my tox station. When a urologist or endo had a question hecalled the pathologist who directed them to me. Did you really work in a hospital? Shite most of the time I had residents who would follow up on questionable labs for me
wnyguy Posted October 10 Posted October 10 1 hour ago, Joe Ferguson forever said: I’ve got a 6 footer for bird. I think it breaks about 4 inches left. Keep your head down and follow through.
Joe Ferguson forever Posted October 10 Posted October 10 5 minutes ago, wnyguy said: I think it breaks about 4 inches left. Keep your head down and follow through. I missed it and a 12 footer the next hole. Tomorrow’s another day 1
Joe Ferguson forever Posted October 10 Posted October 10 32 minutes ago, BillsFanNC said: Well he is Quack, MD after all... Quack is right about one thing. I don't have time to do any of that development work anymore. I now sell instruments, reagents and my consulting time to the scientists doing that type of work. Much better use of my time and it leaves me extra time many days to post here and send him into TDS rage posting. So I've got that going for me, which is nice. c, mon alexei....I'm sure you did a fine job as an orderly in a crappy Russian hospital with no covid tests at all.
Commsvet11 Posted October 10 Posted October 10 32 minutes ago, Joe Ferguson forever said: We don’t have virology departments in our hospitals. These tests are done on cassettes on idiot proof instruments just like chemistries. Even you could do them. But toxicology. Yeah. Different story. And bs, I don’t need to know what subdept of the lab does any test. I used to do plasma catecholamine assays at my tox station. When a urologist or endo had a question hecalled the pathologist who directed them to me. Did you really work in a hospital? Shite most of the time I had residents who would follow up on questionable labs for me See there is another tell “cassette on idiot proof instrument” that’s called a Point of Care instrument and only limited chemistry such as ionized calcium can be done, why don’t you tell us all what a sed rate is and is it clinically significant? 1 1
Joe Ferguson forever Posted October 10 Posted October 10 (edited) 18 minutes ago, Commsvet11 said: See there is another tell “cassette on idiot proof instrument” that’s called a Point of Care instrument and only limited chemistry such as ionized calcium can be done, why don’t you tell us all what a sed rate is and is it clinically significant? This was surprisingly difficult to findhttps://info.cepheid.com/l/287772/2021-08-02/2jln25?utm_campaign=2024-NAM-US-PARENT-PPC-SEARCH-BRAND-PCRplus&utm_medium=cpc&LeadCampaignID=701Hs000002IU3hIAG&utm_source=bing&utm_term=Cepheid pcr&utm_content=broad-match&msclkid=9cc79526d1fa10a40d28f22e92594066 The GeneXpert and GeneXpert Infinity Systems are available in 2 to 80 modules to meet your lab capacity testing needs and can run our entire menu of tests. Cepheid's GeneXpert Xpress utilizes the same cartridge and module technology in a point of care system designed for near-patient healthcare settings capable of running our CLIA-waived respiratory testing menu. let's keep playing. this is good fun/. A sed rate is a nonspecific test for inflammation but can help with some rheumatologic dxes. If it very high a nothing else is suggested, you look for cancer. Obviously many other causes- infection, lupus, polymyalgia rheumatic, temporsal arteritis, nephritis, myocarditis but this is easily searched unlike the methodology for the multi covid test. Edited October 10 by Joe Ferguson forever
Commsvet11 Posted October 10 Posted October 10 10 minutes ago, Joe Ferguson forever said: This was surprisingly difficult to findhttps://info.cepheid.com/l/287772/2021-08-02/2jln25?utm_campaign=2024-NAM-US-PARENT-PPC-SEARCH-BRAND-PCRplus&utm_medium=cpc&LeadCampaignID=701Hs000002IU3hIAG&utm_source=bing&utm_term=Cepheid pcr&utm_content=broad-match&msclkid=9cc79526d1fa10a40d28f22e92594066 The GeneXpert and GeneXpert Infinity Systems are available in 2 to 80 modules to meet your lab capacity testing needs and can run our entire menu of tests. Cepheid's GeneXpert Xpress utilizes the same cartridge and module technology in a point of care system designed for near-patient healthcare settings capable of running our CLIA-waived respiratory testing menu. let's keep playing. this is good fun/. A sed rate is a nonspecific test for inflammation but can help with some rheumatologic dxes. If it very high a nothing else is suggested, you look for cancer. Obviously many other causes- infection, lupus, polymyalgia rheumatic, temporsal arteritis, nephritis, myocarditis but this is easily searched unlike the methodology for the multi covid test. As I said point of care instrument, not the thingy on the idiot proof instrument and you finally got one right “doctor” I’m guessing you had at least two malpractice suits right? 2 1
Joe Ferguson forever Posted October 10 Posted October 10 (edited) 41 minutes ago, Commsvet11 said: As I said point of care instrument, not the thingy on the idiot proof instrument and you finally got one right “doctor” I’m guessing you had at least two malpractice suits right? so educate me. In the hallowed halls of the lab, what is the methodology for rsv, flu, strep, covid multi tests? How do you do all those tests on one nasal swab sample with pipettes, chromatography or bench reagents? My career more than satisfied me. So why was it ok for trump to give scarce testing materials to Putin? You guys do handstands to justify his treason. The best thing for the US would have been putin dying from covid. Edited October 10 by Joe Ferguson forever
Commsvet11 Posted October 10 Posted October 10 38 minutes ago, Joe Ferguson forever said: so educate me. In the hallowed halls of the lab, what is the methodology for rsv, flu, strep, covid multi tests? How do you do all those tests on one nasal swab sample with pipettes, chromatography or bench reagents? My career more than satisfied me. Well for your point of care example of the Cepheid the cartridges have a reagent/master mix of nuclei acid for the specific strain, extracts and amplifies and detects the virus. I could go into more detail such as N2 and E nucleic targets but seeing how you couldn’t respond to NC posts on the subject I doubt you could comprehend 1
Joe Ferguson forever Posted October 10 Posted October 10 (edited) 10 minutes ago, Commsvet11 said: Well for your point of care example of the Cepheid the cartridges have a reagent/master mix of nuclei acid for the specific strain, extracts and amplifies and detects the virus. I could go into more detail such as N2 and E nucleic targets but seeing how you couldn’t respond to NC posts on the subject I doubt you could comprehend A and PCR. so you take the sample, put it on a cassette, push the cassette into the machine and it spits out a result. and you need to calibrate the machine maybe once a day? And even then, physicians will report aberrant results, sometimes requiring recalibration or change of controls. So that part can be challenging I guess. My question was what is the difference in methodology for the in house vs POC tests. Maybe there's a difference but why reinvent a pretty good POC test? Wouldn't America be better off if Putin died from Covid? Edited October 10 by Joe Ferguson forever
Commsvet11 Posted October 10 Posted October 10 8 minutes ago, Joe Ferguson forever said: A and PCR. so you take the sample, put it on a cassette, push the cassette into the machine and it spits out a result. and you need to calibrate the machine maybe once a day? And even then, physicians will report aberrant results, sometimes requiring recalibration or change of controls. So that part can be challenging I guess. Wouldn't America be better off if Putin died from Covid? The process is more involved than that, and physicians have no control over calibration or QC in the laboratory 1
Joe Ferguson forever Posted October 10 Posted October 10 4 minutes ago, Commsvet11 said: The process is more involved than that, and physicians have no control over calibration or QC in the laboratory Dude, if I call Dr Smith or Jones in pathology and say their CBC's seem off - Too many elevated WBC counts for example, They're going to do some peripheral smears manually and check the machine. And call me back after it's done. Wouldn't the world be better off had putin died from covid?
Commsvet11 Posted October 10 Posted October 10 19 minutes ago, Joe Ferguson forever said: Dude, if I call Dr Smith or Jones in pathology and say their CBC's seem off - Too many elevated WBC counts for example, They're going to do some peripheral smears manually and check the machine. And call me back after it's done. Wouldn't the world be better off had putin died from covid? If you called Dr Smith or Dr Jones in pathology they would tell you to ***** off they don’t have time to deal with such a stupid request because QC is done at set times multiple times a day for instruments in laboratories, what are you going to do with that peripheral smear to determine the instrument is incorrect a WBC estimate? In this example you don’t believe the WBC is correct you miss what should be done, either redraw and rerun on a different specimen or add a diff to the cbc to check the neutrophil count for infection that’s what actual physicians do 1
Joe Ferguson forever Posted October 10 Posted October 10 (edited) 9 minutes ago, Commsvet11 said: If you called Dr Smith or Dr Jones in pathology they would tell you to ***** off they don’t have time to deal with such a stupid request because QC is done at set times multiple times a day for instruments in laboratories, what are you going to do with that peripheral smear to determine the instrument is incorrect a WBC estimate? In this example you don’t believe the WBC is correct you miss what should be done, either redraw and rerun on a different specimen or add a diff to the cbc to check the neutrophil count for infection that’s what actual physicians do nope. done it many times. never been told to f off. That would be very bad form. You think they'd do the same when we discuss the path from a biopsy at tumor board? You really don't know how hospitals work, do you? Also, never ordered CBC without diff. That would be MAGA stupid. A 'peripheral smear for pathology review" is one of the most cost effective "consults" one can do. Actual experts then communicate findings with you. Edited October 10 by Joe Ferguson forever
The Frankish Reich Posted October 10 Posted October 10 23 minutes ago, Joe Ferguson forever said: Wouldn't the world be better off had putin died from covid? No fair. That's like that other trick question, "Do you want Ukraine to win?" 1
Commsvet11 Posted October 10 Posted October 10 7 minutes ago, Joe Ferguson forever said: nope. done it many times. never been told to f off. That would be very bad form. You think they'd do the same when we discuss the path from a biopsy at tumor board? You really don't know how hospitals work, do you? Also, never ordered CBC without diff. That would be MAGA stupid. lol you order CBC when a differential has been done for the day for example patient comes in the night before and has a CBC and Diff done the following morning when morning collection is done CBC is ordered because the diff isn’t going to be dramatically different.
Joe Ferguson forever Posted October 10 Posted October 10 1 minute ago, Commsvet11 said: lol you order CBC when a differential has been done for the day for example patient comes in the night before and has a CBC and Diff done the following morning when morning collection is done CBC is ordered because the diff isn’t going to be dramatically different. no idea what this means. my order was always for CBC with diff...and I always got the results although when I saw an unusual trend I let them know and they paid attention. but by all means continue....
Commsvet11 Posted October 10 Posted October 10 8 minutes ago, Joe Ferguson forever said: nope. done it many times. never been told to f off. That would be very bad form. You think they'd do the same when we discuss the path from a biopsy at tumor board? You really don't know how hospitals work, do you? Also, never ordered CBC without diff. That would be MAGA stupid. A 'peripheral smear for pathology review" is one of the most cost effective "consults" one can do. Actual experts then communicate findings with you. A path review consult has established criteria for abnormal findings examples are abnormal cell linage, critically high or low WBC, PLT or anything the tech like me finds deserving, I call my results give the results and slide to path and they either agree with me or add in their own comments for things above my scope 2 minutes ago, Joe Ferguson forever said: no idea what this means. my order was always for CBC with diff...and I always got the results although when I saw an unusual trend I let them know and they paid attention. but by all means continue.... something tells me you don’t understand lab results which makes you a poor doctor 1
Joe Ferguson forever Posted October 10 Posted October 10 (edited) 7 minutes ago, Commsvet11 said: A path review consult has established criteria for abnormal findings examples are abnormal cell linage, critically high or low WBC, PLT or anything the tech like me finds deserving, I call my results give the results and slide to path and they either agree with me or add in their own comments for things above my scope uh huh. And I can request and receive them too. As much as you want to deny it, the machines make mistakes sometimes. I've seen 5.2 become the "normal" potassium level coming out of our lab for several days running until I mentioned it. And it matters. A great deal. Edited October 10 by Joe Ferguson forever
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